Anticoagulation cascade

The multiple effects of UFH on the coagulation cascade may increase its potential to cause hemorrhage." Anticoagulants with more specific sites of action may confer a better safety profile. Two such anticoagulants are low-molecular-weight heparin (LMWH) and heparinoids. 

Anticoagulant Any substance that inhibits, suppresses, or delays the formation of blood clots. These substances occur naturally and regulate the clotting cascade. Several anticoagulants have been identified in a variety of animal tissues and have been commercially developed for therapeutic use. 

Koyama, T., Noguchi, K., Aniya, Y., and Sakanashi, M. (1998). Analysis for sites of anticoagulant action of plancinin, a new anticoagulant peptide isolated from the starfish Acantha-ster planci, in the blood coagulation cascade. Gen. Pharmacol. 31, 277-282. 

The anticoagulant heparin is a polysaccharide sulfate which can form an electrostatic complex with blood-clotting factors (see ASIDE on blood clotting) and prevent the cascade from progressing. 

Figure 12-17 Major components of the human blood clotting cascades. The site of action of the leech anticoagulant protein hirudin is also indicated.

Unlike heparin, the primary advantage of coumarin drugs is that they are administered orally.72 However, because of the nature of their action, there is often a lag time of several days before the decreased production of clotting factors is sufficient to interrupt the clotting cascade and an anticoagulant effect is ap-... 

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